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| People The Johns Hopkins Center on Aging and Health is home to professors, researchers, clinicians, fellows, students and staff with a wide range of scientific expertise and interests, all connected in the common goal of improving health and well-being for older adults. Featured Faculty Dr. Varadhan, an Assistant Professor at COAH, will serve as the leader of an investigative team that includes Drs. Carlos Weiss and Cynthia Boyd from the Division of Geriatric Medicine and Gerontology, Drs. Jodi Segal, Al Wu and Susan Zieman from General Medicine and Cardiology, and Dr. Constantine Frangakis from the Department of Biostatistics. The investigators will review existing approaches to address heterogeneity of treatment effects and to develop new methods to facilitate applicability of trial evidence to target populations, such as older adults, who are poorly represented in clinical trials. We recently had the opportunity to speak with Dr. Varadhan about this award and his research interests. Here are some highlights from our conversation: Can you describe your unique background which spans engineering, statistics and aging research? I have always been most fascinated by mathematics and its power to communicate and illuminate profound concepts in science. Unfortunately, in India the bright young minds are discouraged from pursuing careers in pure disciplines such as mathematics, physics, and chemistry, and are made to choose applied fields such as engineering, medicine, and computer science. The most mathematically inclined students end up pursuing a career in engineering. In my case, I took up chemical engineering. I then came to United State and obtained a PhD in environmental engineering and worked as a research engineer for the U.S. EPA for almost a decade doing mathematical modeling of fate and transport of contaminant chemicals in the groundwater. It was then that I started appreciating the importance of being able to describe and manage the uncertainty in our knowledge of the world. If mathematics is the language of science, then probability and statistics is the language of uncertainty. So, I gave up my career in engineering and pursued another doctorate in biostatistics. During my doctoral program, I was offered a position as a post-doctoral fellow in the Epidemiology and Biostatistics of Aging training program. This was the catalyst for my research interests in aging. What are your key research interests? I have research interests in three areas. I am working on developing a mathematical framework for characterizing the geriatric syndrome of frailty. This involves integrating the idea of dynamical systems from my engineering background, with concepts from stochastic processes from my statistics training. I am also working on developing statistical methods to address the evaluation of effectiveness of treatments and interventions in older adults in the presence of competing causes of death. Last, but definitely not least, I am passionate about developing new computational techniques, as well as implementing existing ones for solving complex modeling problems in biostatistics and aging research. As a former trainee on the Center’s EBA training grant can you speak to how the program influenced your research track? I was fortunate to be offered a position as a post-doctoral fellow in the Epidemiology and Biostatistics of Aging training program. I am convinced that our EBA training program is one of the very best training programs around. Dr. Linda Fried, who was the director of the program, had a very broad outlook on research. She had the foresight to see that the aging research needed infusion of ideas and techniques from a variety of disciplines. In particular, she truly appreciated the critical role of rigorous quantitative thinking. Her leadership, along with that of Dr. Karen Bandeen-Roche, who is now the chairperson of the Department of Biostatistics, is really the foundation for the success of our training program. Linda and Karen constantly challenged me to step out of my comfort zone of statistical modeling and address the real underlying scientific issues of import in any given problem that I happen to be dealing with. Linda called this the “360-degree” approach to thinking about scientific problems. This is best exemplified by the biweekly the Research-in-progress (RIP) meetings at the Center on Aging and Health. These sessions were highlighted by healthy and lively discussions on the statistical, epidemiological, clinical, and social aspects of the scientific topic. I learned a lot from them and I continue to do so. What are the main goals of the AHRQ grant and how do you see this impacting aging research? Currently, randomized clinical trials (RCTs) are considered to provide the most reliable evidence on whether a drug or a medical procedure or any other intervention works. However, it is not clear whether this evidence also applies to groups of people who differ from those participating in the RCTs. If they do differ, can we use additional sources of information (e.g. a prospective observational study) to obtain evidence on the efficacy of the interventions in such groups? If we can, how do we do it? My AHRQ grant is to develop a methodology to address these questions. My research was particularly motivated by the fact that most RCTs do not enroll older adults with multiple chronic health issues, and hence the existing evidence on the efficacy of therapeutics and other interventions is of questionable relevance for them. Therefore, my research has the potential to provide the relevant evidence and also to assess the reliability of that evidence. What advice might you have for junior faculty and students who have similar research interest? It took me a while to figure out my calling in life. So, my advice for junior faculty and students would be that they should keep seeking. Never settle for the easy solution. In the words of my idol Socrates, “the unexamined life is not worth living.” Past Featured Faculty: |
"Congratulations to Dr. Ravi Varadhan on his recent AHRQ award titled, 'Methods to Study the Heterogeneity of Treatment Effects in Comparative Effectiveness Research.'"
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